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1 SIS-3 (9/2021) APPLICATION BY A COMPANY FOR RENEWAL OF A MONEY LENDERS LICENCE Supplementary Information Sheet (Form SIS-3) Section 1 : Company Basic Information (Note 2) Name of the licensee MLR Number CR Number Business Registration Number (please provide the first 8 digits) Contact person (mainly for the information completed on this form) Name : Telephone No. : Email Address : Type of the Money Lenders Listed Company Public Company Private Company Email Address Website Address Number of Employees (including both full- time and part-time employees) Full time: Part-time: Major types of customer loans Unsecured Personal Loans Other Unsecured Loans Secured Loans (excluding property mortgage loan) Property Mortgage Loans Others (please specify) Major source of funding Bank borrowings Shareholders’ funds Debt instruments Intra-conglomerate borrowings Other liabilities (please specify) Sources of new customers Introduction / referral Walk-in Others (please specify) Subsidiary or related entity of a licensed corporation under the Securities and Futures Ordinance (Cap. 571) (“SFO”) Yes; Name of the licensed corporation(s): No Subsidiary or related entity of an authorized institution (Note 3) under the Banking Ordinance (Cap.155) Yes; Name of the authorized institution(s): No Subsidiary or related entity of an insurance company (Note 4) Yes; Name of the insurance company(ies): No

Supplementary Information Sheet (Form SIS-3)

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Page 1: Supplementary Information Sheet (Form SIS-3)

1 SIS-3 (9/2021)

APPLICATION BY A COMPANY FOR RENEWAL OF A MONEY LENDERS LICENCE

Supplementary Information Sheet (Form SIS-3)

Section 1 : Company Basic Information (Note 2)

Name of the licensee

MLR Number

CR Number

Business Registration Number (please provide the first 8 digits)

Contact person (mainly for the information completed on this form)

Name :

Telephone No. :

Email Address :

Type of the Money Lenders

Listed Company Public Company

Private Company

Email Address

Website Address

Number of Employees (including both full-

time and part-time employees) Full time: Part-time:

Major types of customer loans

Unsecured Personal Loans Other Unsecured Loans

Secured Loans (excluding property mortgage loan)

Property Mortgage Loans

Others (please specify)

Major source of funding

Bank borrowings Shareholders’ funds

Debt instruments Intra-conglomerate borrowings

Other liabilities (please specify)

Sources of new customers Introduction / referral Walk-in

Others (please specify)

Subsidiary or related entity of a licensed

corporation under the Securities and Futures

Ordinance (Cap. 571) (“SFO”)

Yes;

Name of the licensed corporation(s):

No

Subsidiary or related entity of an authorized

institution (Note 3) under the Banking

Ordinance (Cap.155)

Yes;

Name of the authorized institution(s):

No

Subsidiary or related entity of an insurance

company (Note 4)

Yes;

Name of the insurance company(ies):

No

Page 2: Supplementary Information Sheet (Form SIS-3)

2

Subsidiary or related entity of an approved

trustee (Note 5) under the Mandatory Provident

Fund Schemes Ordinance (Cap. 485)

Yes;

Name of the approved trustee(s):

No

Subsidiary or related entity of an overseas

banking group, or other overseas financial

institution group

Yes;

Name of the group(s):

Assets consolidated into the group(s): HK$

No

Subsidiary or related entity of a listed

company or overseas listed company

Yes;

Name of the listed company(ies):

No

Subsidiary or related entity of a property

developer

Yes;

Name of the property developer(s):

No

Section 2 : Financial Information

2.1 Abridged Statement of Financial Position as at ( / / ) ( day / month / year )

(Please provide the most recent financial data below and specify the date of the relevant Statement of Financial

Position)

Major items HK$ Million

Assets

(1) Total customer loans (i.e. loans made to general public) (Note 6)

= (i) + (ii) + (iii) + (iv)

(a) maturing within 6 months (i)

(b) maturing over 6 months and within 12 months (ii)

(c) maturing over 12 months and within 60 months (iii)

(d) maturing over 60 months (iv)

(2) Total intra-conglomerate loans = (v) + (vi) + (vii) + (viii) (i.e. loans made to the holding company, the holding company’s other subsidiaries, the

company’s own subsidiaries)

(a) maturing within 6 months (v)

(b) maturing over 6 months and within 12 months (vi)

(c) maturing over 12 months and within 60 months (vii)

(d) maturing over 60 months (viii)

(3) Liquid assets (Note 7)

Page 3: Supplementary Information Sheet (Form SIS-3)

3

Major items HK$ Million

(4) Credit assets other than customer loans, intra-conglomerate loans and liquid

assets (Note 8) = (ix) + (x) + (xi) +(xii)

(a) maturing within 6 months (ix)

(b) maturing over 6 months and within 12 months (x)

(c) maturing over 12 months and within 60 months (xi)

(d) maturing over 60 months (xii)

(5) Other assets = (xiii) + (xiv)

Please specify: ___________________________________________________

(a) maturing within 12 months (xiii)

(b) maturing over 12 months (xiv)

(6) Total assets (Note 9)

= (1) + (2) + (3) + (4) + (5)

of which

(a) maturing within 12 months

(b) are claims on (Note 10) licensed corporations under the SFO in Hong Kong

(c) are claims on (Note 10) authorized institutions (Note 3) in Hong Kong

(d) are claims on (Note 10) insurance companies (Note 4) in Hong Kong

(e) are claims on (Note 10) pension funds (Note 11) in Hong Kong

(f) are claims on (Note 10) other financial institutions / funds (Note 12) in Hong Kong

(g) are claims on (Note 10) financial institutions outside Hong Kong

(h) are claims on (Note 10) listed companies in Hong Kong

(i) are claims on (Note 10) listed companies outside Hong Kong

Page 4: Supplementary Information Sheet (Form SIS-3)

4

Major items HK$ Million

Liabilities

(7) Total bank borrowings = (xv) + (xvi)

comprising: (a) borrowings from banks operating in Hong Kong, including

borrowings from Hong Kong branches of overseas banks

(xv)

(b) borrowings from banks not operating in Hong Kong (xvi)

(8) Total debt instruments issued and outstanding

(9) Total intra-conglomerate borrowings

(10) Other liabilities

Please specify: __________________________________________________

(11) Shareholders' fund

(12) Total liabilities (Note 9)

= (7) + (8) + (9) + (10) + (11)

of which

(a) maturing within 12 months

(b) are liabilities to (Note 13) licensed corporation under SFO in Hong Kong

(c) are liabilities to (Note 13) authorized institutions (Note 3) in Hong Kong

(d) are liabilities to (Note 13) insurance companies (Note 4) in Hong Kong

(e) are liabilities to (Note 13) pension funds (Note 11) in Hong Kong

(f) are liabilities to (Note 13) other financial institutions / funds (Note 12) in Hong Kong

(g) are liabilities to (Note 13) financial institutions outside Hong Kong

(h) are liabilities to (Note 13) listed companies in Hong Kong

(i) are liabilities to (Note 13) listed companies outside Hong Kong

(13) Off-balance sheet items – Total (Note 14)

of which

Credit risk exposure type (Note 15)

Page 5: Supplementary Information Sheet (Form SIS-3)

5

2.2 Breakdown of Total Customer Loans

Breakdown of Total Customer Loans

(Item 1 in Section 2.1) HK$ Million

Personal loans (A) = (B) + (C)

Unsecured personal loans (B)

Secured personal loans (C) = (D) + (H) + (I) + (J)

[[[

[

Major items HK$ Million

Personal loans secured by properties (D) = (E1) + (E2) AND = (F1) + (F2) AND

= (G1) + (G2) + (G3)

Of the total property mortgage loans stated in (D) above

(

E

)

Secured by residential properties (E1)

Secured by commercial / industrial properties (E2)

Of the total property mortgage loans stated in (D) above

For financing the purchase of residential property(ies) concerned (F1)

For any other purposes (F2)

Of the total property mortgage loans stated in (D) above

First mortgages (G1)

Second mortgages (G2)

Third or subsequent mortgages (G3)

Personal loans secured by securities (H)

Personal loans secured by vehicles / licences (e.g. taxi, minibus) (I)

Other secured personal loans (J)

Please specify: ___________________________________________________

Corporate loans (K) = (L) + (M)

Unsecured corporate loans (L)

Secured corporate loans (M) = (N) + (R) + (S) + (T) + (U)

Corporate loans secured by properties (N) = (O1) + (O2) AND = (P1) + (P2) AND =

(Q1) + (Q2) + (Q3)

Of the total property mortgage loans stated in (N) above

(

E

)

Secured by residential properties (O1)

Secured by commercial / industrial properties (O2)

Of the total property mortgage loans stated in (N) above

For financing the purchase of residential property(ies) concerned (P1)

For any other purposes (P2)

Page 6: Supplementary Information Sheet (Form SIS-3)

6

Major items HK$ Million HK$ Million

Of the total property mortgage loans stated in (N) above

First mortgages (Q1)

Second mortgages (Q2)

Third or subsequent mortgages (Q3)

Corporate loans secured by securities (R)

Corporate loans secured by vehicles / licences (e.g. taxi, minibus) (S)

Corporate loans secured by machinery (T)

Corporate loans secured by others (U)

Please specify: ____________________________________________________

Total customer loans = (A) + (K) (Note 6)

2.3 Audited Financial Statement

Please attach a copy of the company’s Audited Financial Statement in support of the information provided in Sections

2.1 and 2.2

Period covered by the Financial Statement

2.4 Loans referred by third party(ies) (Note 16)

Total amount of customer loans

= (1) of Section 2.1

Loans referred by third party(ies) Amount: %

of total customer loan

Loans not referred by third

party(ies) Amount: %

of total customer loan

Page 7: Supplementary Information Sheet (Form SIS-3)

7

Section 3 : Operational Information

3.1 Has the company been the subject of complaints to the Police regarding its

money lender business since the granting of the last money lenders licence?

Yes No

3.2 Has the company received any warning letters from the Police Licensing Office

since the granting of the last money lenders licence?

Yes No

3.3 Has the company complied with all the provisions of the Money Lenders

Ordinance in carrying on the money lender business since the granting of the

last money lenders licence?

Yes No

Section 4 : Money Laundering and Terrorist Financing Risk Management and Control

4.1 Has the company put in place adequate and appropriate policies, procedures and

controls to comply with the anti-money laundering and counter-terrorist

financing (AML/CTF) requirements, including but not limited to compliance

management arrangements, ongoing employee training programme and

independent audit function to test the AML/CTF system, as evidenced by policy

statement(s) or other written documents?

If not, please explain:

Yes

No

4.2 (a) Before establishing business relationships with customers or before carrying

out transactions for customers, has the company taken customer due

diligence (CDD) measures to identify and verify the identity of the

customers and their beneficial owners?

If not, please explain:

________________________________________________________

________________________________________________________

________________________________________________________

(b) Before establishing business relationships with customers or before carrying

out transactions for customers, has the company obtained information on

the purpose and intended nature of the business relationships established

with the company?

If not, please explain:

________________________________________________________

________________________________________________________

________________________________________________________

Yes

Yes

No

No

Page 8: Supplementary Information Sheet (Form SIS-3)

8

(c) Has the company conducted ongoing due diligence on the business

relationship, including ensuring that the transactions being conducted are

consistent with the company’s knowledge of the customer, the

customer’s business and risk profile, including where necessary, the

source of funds, and ensuring that documents, data or information

collected under the CDD process is kept up-to-date and relevant, by

undertaking reviews of existing records, particularly for higher risk

categories of customers?

If not, please explain:

_________________________________________________________

_________________________________________________________

Yes

No

4.3 (a) Has the company kept records of customers obtained through CDD

measures throughout the continuance of the business relationships with the

customers and for a period of at least 5 years after the end of business

relationships?

If not, please explain:

_________________________________________________________

_________________________________________________________

(b) Has the company kept records of transactions for at least 5 years after the

completion of transactions?

If not, please explain:

_________________________________________________________

_________________________________________________________

Yes

Yes

No

No

4.4 Has the company carried out enhanced CDD measures when dealing with

situations which present a high risk of money laundering or terrorist financing

(e.g. customers have not been physically present for identification purposes or

where the customers or beneficial owners are politically-exposed persons (PEPs)

or from high-risk jurisdictions or from countries for which this is called for by

the Financial Action Task Force (FATF)) (Note 17)?

If not, please explain:

Is senior management approval needed before establishing such business

relationship?

Yes

Yes

No

No

4.5 Did the company rely on third parties (“intermediaries”) to carry out CDD

measures or introduce business?

If not, please skip 4.5(a), (b) and (c).

If yes, :

(a) Are the third parties financial institutions (Note 18), lawyers, accountants, trust

or company service providers or estate agents?

Yes

Yes

No

No

Page 9: Supplementary Information Sheet (Form SIS-3)

9

(b) Have the third parties consented in writing to be the company’s

intermediaries?

If not, please explain:

_________________________________________________________

_________________________________________________________

(c) Is the company satisfied that:

(i) the intermediaries will carry out CDD measures to identify and

verify the identity of the customers and their beneficial owners?

If not, please explain:

_____________________________________________________

_____________________________________________________

(ii) the intermediaries will on request provide a copy of any document,

or a record of any data or information, obtained by the intermediaries

in the course of carrying out CDD measures without delay?

If not, please explain:

_____________________________________________________

_____________________________________________________

(iii) the intermediaries have measures in place for compliance with CDD

and record-keeping requirements?

If not, please explain:

_____________________________________________________

_____________________________________________________

Yes

Yes

Yes

Yes

No

No

No

No

4.6 Has the company put in place risk assessment systems or procedures to assess

money laundering and terrorist financing risks prior to the launch or use of new

products, practices and technologies?

If not, please explain:

Yes No

4.7 Has the company put in place a system or procedures to submit suspicious

transaction reports to the Joint Financial Intelligence Unit as required under the

Organized and Serious Crimes Ordinance (Cap. 455), Drug Trafficking

(Recovery of Proceeds) Ordinance (Cap. 405) and United Nations (Anti-

Terrorism Measures) Ordinance (Cap. 575)?

If not, please explain:

Yes No

Page 10: Supplementary Information Sheet (Form SIS-3)

10

4.8 Has the company provided staff with appropriate training on prevention and

detection of money laundering and terrorist financing activities, including

training to raise their awareness of business practices against money laundering

or terrorist financing?

If yes, how is the effectiveness of the training monitored?

If not, please explain:

Yes No

4.9

Has the company provided its staff with policies or guidelines in relation to the

conduct of CDD, criteria for identifying suspicious transactions, and relevant

AML/CTF measures for reference?

If not, please explain:

Yes No

4.10 Does the company have any foreign branches or majority-owned subsidiaries?

If yes, has the company ensured that its branches and subsidiaries apply

AML/CTF measures consistent with the company’s programme?

Yes

Yes

No

No

4.11 Please describe how the company established an independent audit function to enable it to carry out

its responsibilities, including independent reviews of its AML/CTF systems.

4.12 (a) Is the company operating as a financial group?

If not, please skip 4.12(b).

(b) If yes, has the company implemented group-wide programmes against

money laundering and terrorist financing, which should be applicable, and

appropriate to, all branches and majority-owned subsidiaries of the financial

group?

If the answer to (b) is “No”, please explain:

Yes

Yes

No

No

Page 11: Supplementary Information Sheet (Form SIS-3)

11

Section 5 : Risk Assessment

Customer Risk

5.1 Total number of customers (since the date of granting the last money lenders

licence)

__________

5.2 In relation to customers’ residence

(a) Number of customers with residence in or connection with countries subject to

sanctions, embargos or similar measures issued by, for example, the United

Nations

__________

(b) Number of customers with residence in or connection with countries/areas

identified by credible sources (Note 19) as:

(i) providing funding or support for terrorist activities or that have designated

terrorist organisations operating within them

__________

(ii) having significant levels of corruption or other criminal activity __________

(iii) lacking appropriate AML/CTF laws, regulations and other measures

including countries identified by the statements of FATF as having weak

AML/CTF regimes

__________

(c) Total number of customers involved in the risk factors under Section 5.2(a) and

(b) (note: a customer involved in more than one risk factors should be counted

once only)

__________

5.3 In relation to customers

(a) Number of customers who are sanctioned by the relevant national competent

authority for non-compliance with the applicable AML/CTF regime

__________

(b) Number of customers who is a PEP or whose family members or close

associates are PEPs (including where a beneficial owner of the customer is a

PEP)

__________

(c) Number of customers whose primary source of income originates from high-

risk jurisdictions

__________

(d) Number of customers with complex or non-transparent ownership/control

structure (for example, structure involving multiple layers, different

jurisdictions, trusts, the use of bearer shares etc)

__________

(e) Number of customers having been mentioned in negative news reports from

credible media, particularly those related to predicate offences for money

laundering and terrorist financing or to financial crimes

__________

(f) Number of customers engaging in, or deriving wealth or revenues from, a high-

risk cash-intensive business

__________

Page 12: Supplementary Information Sheet (Form SIS-3)

12

(g) Number of customers who have funds that are obviously and inexplicably

disproportionate to their circumstances (e.g. their age, income, occupation or

wealth)

__________

(h) Number of customers with substantial business operation outside Hong Kong __________

(i) Total number of customers involved in the risk factors under Section 5.3(a) to

(h) (note: a customer involved in more than one risk factors should be counted

once only)

__________

Product / Service Risk

5.4 Total amount of loans (HK$ Million) (since the date of granting the last money lenders licence)

__________

5.5 Total number of loans (since the date of granting the last money lenders licence) __________

of which

(a) Number of loans with the size within HK$1 million

(b) Number of loans with the size over HK$1 million and within HK$5 million

(c) Number of loans with the size over HK$5 million

__________

__________

__________

5.6 In relation to customer loans

(a) Number of loans either wholly or partially paid out to third parties __________

(b) Number of loans involving repayment (including principal, interest or any other

fee) received from, or repayment instructions given by, associated, unknown or

unexpected third parties

__________

(c) Total number of loans involved in the risk factors under Section 5.6(a) and (b)

(note: a loan involved in more than one risk factors should be counted once only)

__________

(d) Number of loans involving repayment using physical cash __________

(e) Number of loans involving repayment by way of virtual assets and other

anonymous means of payment

__________

5.7 Please list out the new technologies and payment methods which are used in your money lending

business:

Page 13: Supplementary Information Sheet (Form SIS-3)

13

Distribution channel risk

5.8 Number of loan transactions which adopt a non-face-to-face approach for

establishing a business relationship with a customer (e.g. online, postal, telephone

channels)

__________

Section 6 : Disciplinary Actions

Has

the company;

any of the directors or other controlling persons of the company;

another company of which the company is or was a corporate director; or

another company of which the company is or was a principal shareholder

previously been

refused or restricted, in Hong Kong or elsewhere, from the right to carry on any trade,

business or profession for which a specific licence, registration or other authorisation

is required by law?

If so, please provide details

censored, disciplined or disqualified by any professional or regulatory body in Hong

Kong or elsewhere in relation to any trade, business or profession?

If so, please provide details

Yes

Yes

No

No

Section 7 : Declaration

I hereby declare that :

(1) the company does not have any business relationship with any relevant person or relevant entity (as

defined under the United Nations Sanctions Ordinance (Cap. 537) or any subsidiary legislation

thereunder) which is subject to financial sanctions or any terrorist or terrorist associate as defined under

the United Nations (Anti-Terrorism Measures) Ordinance (Cap. 575). (Note 20)

(2) all the information provided in this form is complete, true and correct.

For and on behalf of

(Name of the company)

Signature

Name of person authorised

by the company (Note 21) Date

(day / month / year)

Page 14: Supplementary Information Sheet (Form SIS-3)

14

Note

1. Please use a separate sheet to continue if there is insufficient space provided for your answer.

2. Please provide information since the granting of the last money lenders licence.

3. Authorized institutions, as defined under the Banking Ordinance (Cap. 155), include banks, restricted licence

banks and deposit-taking companies.

4. Insurance companies refer to companies specified under section 6(1) of the Insurance Ordinance (Cap. 41).

5. Approved trustee has the meaning given in section 2(1) of the Mandatory Provident Fund Schemes Ordinance

(Cap. 485).

6. The amount of total customer loans appearing in item (1) of Section 2.1 should be the same as the amount which

appears as the total in Section 2.2 [i.e. (A) + (K) in Section 2.2].

7. Liquid assets include cash and cash equivalents (i.e. assets which can be easily and immediately converted into

cash at little or no loss of value).

8. Credit assets include investments in debt securities, government debt and other debt instruments.

9. The amount of total assets [see Item (6) of Section 2.1] should be the same as that of total liabilities [see Item

(12) of Section 2.1].

10. Claims include balance sheet asset exposures that arise through credit provision (loans, bonds held, cash on

deposits, trade credit/loans, reverse repos) but exclude investment in equity.

11. Pension funds refer to funds under the Mandatory Provident Fund Schemes and the Occupational Retirement

Schemes.

12. Other financial institutions / funds may include Money Market Funds, Hedge Funds, Other Investment Funds,

Real Estate Investment Trusts, Real Estate Funds, Trust Companies, Broker Dealers, Structured Finance

Vehicles, and Central Counterparties etc.

13. Liabilities include balance sheet liability exposures that arise from borrowing activity (e.g. loans, deposits

(where applicable), trade credit, repos) and equity investments.

14. The absolute sum of all long and short off-balance sheet positions.

15. Off-balance sheet credit risk exposures, e.g. due to contingent liabilities such as credit guarantees or lines of

credit.

16. Third party(ies) refer(s) to any third party with whom the intending borrower has entered into an agreement for

or in relation to the referral or the loan.

17. High-risk jurisdictions include but are not limited to:

(a) those that have been identified by the FATF as jurisdictions with strategic AML/CTF deficiencies;

(b) countries subject to sanctions, embargos or similar measures issued by, for example, the United Nations;

(c) countries which are vulnerable to corruption; and

(d) countries that are believed to have strong links to terrorist activities.

18. Financial institutions include:

(a) authorized institutions;

(b) licensed corporations:

(c) authorized insurers;

(d) appointed insurance agents; and

(e) authorized insurance brokers.

19. “Credible sources” refers to information that is produced by reputable and universally recognized international

organisations and other bodies that make such information publicly and widely available. In addition to the

FATF and FATF-style regional bodies, such sources may include, but are not limited to, supra-national or

international bodies such as the International Monetary Fund, the World Bank and the Egmont Group of

Financial Intelligence Units.

20. The relevant lists are available at “Compliance > Anti-Money Laundering and Counter-Terrorist Financing”

section of the website at www.cr.gov.hk. It is an offence for any person to make available any funds or other

financial assets or economic resources to or for the benefit of relevant persons or relevant entities; or to deal

with any funds, other financial assets or economic resources belonging to, owned or controlled by, such persons

or entities, except under the authority of a licence granted by the Chief Executive.

21. Please produce evidence of authorisation.